Deep brain stimulation for epilepsy: Dr. Robert Fisher

Send comments and feedbackCan electrical current stop seizures, or make seizures less severe? How does it work, and who can benefit?  Dr. Laurent Sheybani interviews Dr. Robert Fisher about deep-brain stimulation for epilepsy.Disclosure: Dr. Fisher is a consultant for Medtronic but receives no compensation for using its deep-brain stimulation devices.Deep-brain stimulation (DBS) is the newest of three types of neuromodulation for epilepsy, and targets a part of the thalamus called the anterior nucleus. In DBS treatment, targeted electrical pulses inhibit  a network in the brain  involved in starting and spreading seizures. This interference is linked with a reduction in the number and/or severity of seizures in some people who haven’t found relief with anti-seizure medications.In a randomized, double-blind study of DBS, the SANTE trial , 43% of people had significant reductions in their seizure frequency after one year, and 74% had reductions after 7 years. The treatment also had high patient satisfaction (84% after 7 years).The mechanisms of DBS are still largely unknown, though pre-clinical studies have found synaptogenesis, receptor changes, and changes in gene expression, suggesting the growth or regeneration of neurons. DBS is usually well tolerated, acceptably safe, and associated with improvement in quality of life.Research discussed during the episode:Electrical stimulation of the anterior nucleus of thalamus for treatment of refractory epilepsy (2010) Epilepsia (Fisher R, Salanova V, Witt T, for the SANTE study group)Experience and consensus on stimulation of the anterior nucleus of thalamus for epilepsy (2021) Epilepsia (Fasano A, Eliashiv D, Herman ST, et al.)Closed-loop stimulation of the medial septum terminates epileptic seizures (2021) Brain (Takeuchi Y, Harangozo M, Pedraza L, et al.)Medial septal GABAergic neurons reduce seizure duration upon optogenetic closed-loop stimulation (2021) Brain (Hristova K, Martinez-Gonzalez C, Watson TC, et al.) Other resources:ILAE/YES webinar on neurostimulation with Dr. Robert Fisher (January 2022)This episode was reported by Dr. Laurent Sheybani, and edited and produced by Nancy Volkers.Sharp Waves content is meant for informational purposes only and not as medical or clinical advice. The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, Twitter, and Instagram. Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.Let us know how we're doing:  [email protected] International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, Instagram, and LinkedIn.